Over the last decade there has been a remarkable increase in the use of information technology in both learning and training of dental procedures using computer simulators. The use of a dental simulator has proved to increase patient safety and reduce risk associated with human errors by allowing dental students to develop skills more efficiently in a shorter period of time.
In particular, acquiring abilities and skills to perform periodontal procedures takes more than observing patients, diagnosing and managing the disease, but also needs a practical experience of the tactile sensation. Traditionally, dental and dental hygiene students gain such expertise in the laboratory through two stages: first, students train on artificial teeth placed within a manikin head, using real dental instruments, and second, students perform periodontal procedures on real patients under the close supervision of their professors. Existing simulation tools do not allow students to learn about the material properties of the organs (the feel of soft tissues or bone texture).
Dental simulators have been developed both in the academia and the industry. The concept design of a Virtual Reality Dental Training (VRDT) system was introduced in the late nineties to practice cavity preparation. Thomas et al. developed a training system that enables an operator to practice the detection of carious lesions. In recent years, more powerful dental simulation tools have been developed including the Virtual Reality Dental Training System (VRDTS), Iowa Dental Surgical Simulator (IDSS), and 3DDental (no longer available). Several companies have been focusing on developing commercial dental training systems. Simodont™ was developed by MOOG, Inc., and can simulate drilling and mirror reflection. Forsslind Dental System™ was developed to practice dental drilling and wisdom teeth extraction.
Periodontal procedures require clinicians to depend primarily on their tactile sensation, for both diagnostic and surgical procedures. This makes haptic technology ideally suited for periodontal simulators. The PerioSim simulator was developed to simulate three operations: pocket probing, calculus detection, and calculus removal. Wang et al. developed a haptics-based dental simulator (iDental) and presented a user evaluation that included qualitative and quantitative analysis. Results suggested that it is necessary to use 6-DOF haptic rendering for multi-region contacts simulation. Furthermore, a more practical dental simulator must include simulation of deformable body such as tongue and gingival, and simulation of occlusion of tongue and cheek on teeth, etc.
Even though prior work has proven to be a successful tool for faster acquisition of skills and has resulted in overall positive student perception, there remain few challenges. First of all, the quality of user immersion is not sufficient; the users use the haptic device stylus to interact with the simulation environment and do not use real dental instruments. Second, two-hands simulation must be supported to recreate two-instruments interaction experience. Finally, the fulcrum is not realistic since there is no simulation of finger support. General haptic support devices have been developed, but such devices have typically focused on supporting the arm to allow the hand to move freely. Therefore, a system that simulates periodontal procedures both haptically and graphically will be a better solution to increase learners' knowledge/experience level before performing on live patients.